CRAO - Fluorescein Angiogram Shows Non-perfusion
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85-year-old woman who had sudden severevision loss in the left eye two weeks ago. Since then she has already had a carotid and cardiac studies done. As far as she has been informed all her testing has been normal. Her vision in the left eye is starting to improve slightly and she can see a little more centrally and much more in the periphery, since about the last four days.
VISUAL ACUITY: OD 20/30, OS: Hand motion. IOP: OD 10, OS 11.
SLIT EXAMINATION: There is 3+ nuclear sclerosis in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. The macula and periphery look healthy.
OS: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There are multiple white spots around the macula. There is a cherry red spot centrally. Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows filling of the central retinal arteries starting about 13 seconds after the injection of dye, however, the recirculation time is very slow at about 20 seconds. The right eye appears to have reasonably normal vasculature on the angiogram.
IMPRESSION:
1. CENTRAL RETINAL ARTERY OCCLUSION – LEFT EYE PARTIALLY REPERFUSED
2. CATARACTS – BOTH EYES
DISCUSSION: I explained to the patient she does unfortunately have a central retinal artery occlusion in the left eye. The circulation there looks like it is starting to improve some. The blood is filling the retinal vessels fairly quickly, however, the circulation time is still slow. I asked her to see you back regularly. I told her she does not need to return here unless you or she note further problems
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Central Retinal Artery Occlusion Left Eye 2 Weeks Old - Still Non-Perfusion710 views85-year-old woman who had sudden severevision loss in the left eye two weeks ago. she can see a little more centrally and much more in the periphery, since about the last four days.
VISUAL ACUITY: OD 20/30, OS: Hand motion     (0 votes)
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Central Retinal Artery Occlusion Left Eye 2 Weeks Old - Still Non-Perfusion687 views85-year-old woman who had sudden severevision loss in the left eye two weeks ago. she can see a little more centrally and much more in the periphery, since about the last four days.
VISUAL ACUITY: OD 20/30, OS: Hand motion     (0 votes)
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Central Retinal Artery Occlusion Left Eye 2 Weeks Old - Still Non-Perfusion601 views85-year-old woman who had sudden severevision loss in the left eye two weeks ago. she can see a little more centrally and much more in the periphery, since about the last four days.
VISUAL ACUITY: OD 20/30, OS: Hand motion     (0 votes)
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Central Retinal Artery Occlusion Left Eye 2 Weeks Old - Still Non-Perfusion623 views85-year-old woman who had sudden severevision loss in the left eye two weeks ago. she can see a little more centrally and much more in the periphery, since about the last four days.
VISUAL ACUITY: OD 20/30, OS: Hand motion     (0 votes)
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Central Retinal Artery Occlusion Left Eye 2 Weeks Old - Still Non-Perfusion717 views85-year-old woman who had sudden severevision loss in the left eye two weeks ago. she can see a little more centrally and much more in the periphery, since about the last four days.
VISUAL ACUITY: OD 20/30, OS: Hand motion     (0 votes)
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Central Retinal Artery Occlusion Left Eye 2 Weeks Old - Still Non-Perfusion614 views85-year-old woman who had sudden severevision loss in the left eye two weeks ago. she can see a little more centrally and much more in the periphery, since about the last four days.
VISUAL ACUITY: OD 20/30, OS: Hand motion     (0 votes)
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Central Retinal Artery Occlusion Left Eye 2 Weeks Old - Still Non-Perfusion568 views85-year-old woman who had sudden severevision loss in the left eye two weeks ago. she can see a little more centrally and much more in the periphery, since about the last four days.
VISUAL ACUITY: OD 20/30, OS: Hand motion     (0 votes)
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Central Retinal Artery Occlusion Left Eye 2 Weeks Old - Still Non-Perfusion743 views85-year-old woman who had sudden severevision loss in the left eye two weeks ago. she can see a little more centrally and much more in the periphery, since about the last four days.
VISUAL ACUITY: OD 20/30, OS: Hand motion     (0 votes)
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Central Retinal Artery Occlusion Left Eye 2 Weeks Old - Still Non-Perfusion701 views85-year-old woman who had sudden severevision loss in the left eye two weeks ago. she can see a little more centrally and much more in the periphery, since about the last four days.
VISUAL ACUITY: OD 20/30, OS: Hand motion     (0 votes)
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Central Retinal Artery Occlusion Left Eye 2 Weeks Old - Still Non-Perfusion585 views85-year-old woman who had sudden severevision loss in the left eye two weeks ago. she can see a little more centrally and much more in the periphery, since about the last four days.
VISUAL ACUITY: OD 20/30, OS: Hand motion     (0 votes)
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Central Retinal Artery Occlusion Left Eye 2 Weeks Old - Still Non-Perfusion550 views85-year-old woman who had sudden severevision loss in the left eye two weeks ago. she can see a little more centrally and much more in the periphery, since about the last four days.
VISUAL ACUITY: OD 20/30, OS: Hand motion     (0 votes)
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Central Retinal Artery Occlusion Left Eye 2 Weeks Old - Still Non-Perfusion491 views85-year-old woman who had sudden severevision loss in the left eye two weeks ago. she can see a little more centrally and much more in the periphery, since about the last four days.
VISUAL ACUITY: OD 20/30, OS: Hand motion     (0 votes)
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Central Retinal Artery Occlusion Left Eye 2 Weeks Old - Still Non-Perfusion513 views85-year-old woman who had sudden severevision loss in the left eye two weeks ago. she can see a little more centrally and much more in the periphery, since about the last four days.
VISUAL ACUITY: OD 20/30, OS: Hand motion     (0 votes)
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Central Retinal Artery Occlusion Left Eye 2 Weeks Old - Still Non-Perfusion546 views85-year-old woman who had sudden severevision loss in the left eye two weeks ago. she can see a little more centrally and much more in the periphery, since about the last four days.
VISUAL ACUITY: OD 20/30, OS: Hand motion     (0 votes)
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Central Retinal Artery Occlusion Left Eye 2 Weeks Old - Still Non-Perfusion565 views85-year-old woman who had sudden severevision loss in the left eye two weeks ago. she can see a little more centrally and much more in the periphery, since about the last four days.
VISUAL ACUITY: OD 20/30, OS: Hand motion     (0 votes)
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85-year-old woman who had sudden severevision loss in the left eye two weeks ago. Since then she has already had a carotid and cardiac studies done. As far as she has been informed all her testing has been normal. Her vision in the left eye is starting to improve slightly and she can see a little more centrally and much more in the periphery, since about the last four days.
VISUAL ACUITY: OD 20/30, OS: Hand motion. IOP: OD 10, OS 11.
SLIT EXAMINATION: There is 3+ nuclear sclerosis in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. The macula and periphery look healthy.
OS: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There are multiple white spots around the macula. There is a cherry red spot centrally. Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows filling of the central retinal arteries starting about 13 seconds after the injection of dye, however, the recirculation time is very slow at about 20 seconds. The right eye appears to have reasonably normal vasculature on the angiogram.
IMPRESSION:
1. CENTRAL RETINAL ARTERY OCCLUSION – LEFT EYE PARTIALLY REPERFUSED
2. CATARACTS – BOTH EYES
DISCUSSION: I explained to the patient she does unfortunately have a central retinal artery occlusion in the left eye. The circulation there looks like it is starting to improve some. The blood is filling the retinal vessels fairly quickly, however, the circulation time is still slow. I asked her to see you back regularly. I told her she does not need to return here unless you or she note further problems